An epidemiological study of visceral leishmaniasis in North East Ethiopia using serological and leishmanin skin tests


Autoři: Desalegn Tadese aff001;  Asrat Hailu aff002;  Fitsum Bekele aff003;  Shewaye Belay aff001
Působiště autorů: Institute of Biomedical Science, College Health Science, Mekelle University, Mekele, Ethiopia aff001;  Department of Microbiology, Immunology & Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia aff002;  Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia aff003
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225083

Souhrn

Background

In Ethiopia, visceral leishmaniasis (VL) is caused by Leishmania donovani. The estimated country-wide incidence of VL in Ethiopia is 3700–7400 cases/year. The balance between anthroponotic and zoonotic transmission is still unknown even though most authors believe that visceral leishmaniasis in East Africa is anthroponotic. Asymptomatic leishmania infections occur more frequently than clinically apparent visceral leishmaniasis cases. The aim of this study was to determine the prevalence of asymptomatic VL infection and assess the degree of exposure among residents in Raya Azebo Woreda villages where cases of VL were recently reported.

Methods

A community based cross-sectional survey was conducted in 2013 between 1st of May and 25th of July. A total of 1099 individuals living in 314 households were included in the study. Socio-demographic and clinical data were collected from each of the participants and venous blood was also collected for the detection of antibodies to visceral leishmaniasis using Direct Agglutination Test. Leishmanin skin test was performed to detect the exposure to the parasite. Data was entered into excel and exported to SPSS version 17 for statistical analysis. Chi-square and the corresponding p-values were used to determine the statistical significance of the proportions/ratios obtained from the cross tabulated data. A p-value < 0.05 was considered statistically significant.

Result

A total of 1099 study subjects comprising 401 males and 698 females were included in the study. The overall positive leishmanian skin test and sero-prevalence rates respectively were 9.08% and 0.87%. The difference in LST positivity by age group and sero-prevalence by sex were statistically significant (P <0.01 and P<0.05 respectively). Out of the 9 sero-positive individuals, 7 had no history of travel to visceral leishmaniasis endemic areas out of Raya Azebo.

Conclusion

In general our results suggest occurrence of VL in the study area is, very low. Our survey also indicates that due to the low incidence of the disease, and lack of awareness, some patients remain under diagnosed.

Klíčová slova:

Age groups – Epidemiology – Ethiopia – Kala-azar – Leishmania donovani – Leishmaniasis – Serology – Skin tests


Zdroje

1. Alvar J, Yactayo S, Bern C. Leishmaniasis and poverty. Trends Parasitol. 2006; 22(12):552–7. doi: 10.1016/j.pt.2006.09.004 17023215

2. de Menzes JP, Saraiva EM and da Rocha-Azevedo B. The site of the bite: Leishmania interaction with macrophages, neutrophils and the extracellular matrix in the dermis. Parasit & Vectors 2016; 9:264

3. Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE 2012; 7(5):e35671. doi: 10.1371/journal.pone.0035671 22693548

4. Hailu A, Argaw D and Boelaert M. Leishmaniasis. In: Neglected Tropical Diseases—Sub-Saharan Africa. 2016; Eds. Gyapong J & Boatin B. Springer International Publishing AG., Switzerland. ISSN 2194-8275; https://doi.org/10.1007/978-3-319-25471-5 pp 87–112

5. FMOH. Guideline for Diagnosis, Treatment and Prevention of Leishmaniasis in Ethiopia. Second ed.; Addis Ababa, Ethiopia: Ethiopian Federal Ministry of Health; 2013

6. Gadisa E, Tsegaw T, Abera A, Elnaiem DE, den Boer M, Aseffa A. and Jorge A. Eco-epidemiology of visceral leishmaniasis in Ethiopia. Parasit & Vectors 2015; 8:381.

7. Bekele F, Belay T, Zeynudin A, Hailu A (2018) Visceral leishmaniasis in selected communities of Hamar and Banna-Tsamai districts in Lower Omo Valley, South West Ethiopia: Seroepidemological and Leishmanin Skin Test Surveys. PLoS ONE 13(5): e0197430. doi: 10.1371/journal.pone.0197430 29795589

8. Abera A, Tasew G, Tsegaw T, Kejella A, Mulugeta A, Worku D et. al (2016) Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia:Reemerging or Emerging? Am. J. Trop. Med. Hyg., 95(1), 2016, pp. 104–108 doi: 10.4269/ajtmh.15-0738 27139445

9. Hailu A., Berhe N., Ali A. and Gemetchu T. The use of Leishmania major derived leishmanin in the skin test surveys of visceral leishmaniasis in Ethiopia. East Afr Med J 1997; 74(1): 41–45. 9145577

10. Meredith SE, Kroon NC, Sondorp E, Seaman J, Goris MG, van Ingen CW, Oosting H, Schoone GJ, Terpstra WJ and Oskam L. Leish-KIT, a stable direct agglutination test based on freeze-dried antigen for serodiagnosis of visceral leishmaniasis. J Clin Microbiol 1995; 33(7):1742–45 7665640

11. Ali A, Berhe N, Mengistu G, Gebre-Michael T. Leishmaniasis survey in the Awash Valley: The magnitude of positive leishmanin reaction and its pattern in the Middle Awash. Ethiop J Health Dev 2002; 16 (2):157–63.

12. Ali A, Gebre-Michael T, Mengistu G, Balcha F. A survey on leishmaniasis and the leishmanin skin test profile in Lower Awash Valley, northeast Ethiopia. Ethiop J Health Dev 2004; 18(3):159–163

13. Hailu A, Gramiccia M, Kager PA. Visceral leishmaniasis in Aba-Roba, south-western Ethiopia: prevalence and incidence of active and subclinical infections. Ann Trop Med Parasitol 2009; 103(8):659–70. doi: 10.1179/000349809X12554106963555 20030990

14. Alvar J, Bashaye S, Argaw D et al. Kala-azar outbreak in Libo Kemkem, Ethiopia: epidemiologic and parasitologic assessment. Am J Trop Med Hyg 2007; 77: 275–282 17690399

15. Ho M, Siongok TK, Lyerly WH and Smith DH. Prevalece and disease spectrum in a new focus of viseeral leishmaniasis in kenya. Trans R Soc Trop Med Hyg 1982; 76: 741–746 doi: 10.1016/0035-9203(82)90095-5 6984547

16. Custodio E, Gadisa E, Sordo L et al. Factors associated with Leishmania asymptomatic infection: results from a cross-sectional survey in highland northern Ethiopia. PLoS Negl Trop Dis 2012; 6: e1813 doi: 10.1371/journal.pntd.0001813 23029576

17. Menten J., Boelaert M., and Lesaffre E., “Bayesian meta-analysis of diagnostic tests allowing for imperfect reference standards,” Statistics in Medicine, vol. 32, no. 30, pp. 5398–5413, 2013. doi: 10.1002/sim.5959 24003003

18. Hailu A, Berhe N, Sisay Z, Abraham I, Medhin G. Sero-epidemiological and leishmanin skin test surveys of visceral leishmaniasis in south and southwest Ethiopia. Ethiop Med J 1996; 34(1):11–23. 8674496

19. Hailu A, Berhe N, Yeneneh H. Visceral leishmaniasis in Gambela, western Ethiopia. Ethiop Med J 1996; 34:33–42. 8674498

20. Khalil E, Zijlstra E. Epidemiology and clinical manifestations of Leishmaniadonovani infection in two villages in an endemic area in Eastern Sudan. Trop Med & Intl Health 2003; 7(1): 35–44

21. Bsrat A, Berhe N, Balkew M, et al. Epidemiological study of cutaneous leishmaniasis in Saesie Tsaeda-emba district, eastern Tigray, northern Ethiopia. Parasit Vectors. 2015; 8:149. Published 2015 Mar 7. doi: 10.1186/s13071-015-0758-9 25889827

22. Sadeghian G, Ziaei H, Bidabadi LS, Nilforoushzadeh MA. Evaluation of leishmanin skin test reaction in different variants of cutaneous leishmaniasis. Indian J Dermatol. 2013;58(3):239. doi: 10.4103/0019-5154.110838 23723480


Článek vyšel v časopise

PLOS One


2019 Číslo 12